Breast Tumor Resembling the Tall Cell Variant of Papillary Thyroid Carcinoma: Report of 4 Cases With Evidence of Malignant Potential

Tosi, Anna Lisa; Ragazzi, Moira; Asioli, Sofia; Vecchio, Marina Del; Cavalieri, Monica; Eusebi, Leonardo Henry; Foschini, Maria Pia

doi:10.1177/1066896906295689

Cited by 52 publications

(50 citation statements)

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“…[4][5][6] Eusebi et al 4 first described a series of five breast neoplasms all of which displayed solid and papillary areas composed of columnar to cuboidal eosinophilic cells with grooved nuclei; there was variable nuclear clearing and two cases also displayed intranuclear inclusions. Myoepithelial cells were evident in three cases suggesting at least a focal in situ component.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 In addition to displaying nuclear features characteristic of papillary thyroid carcinoma, all 10 reported cases had unequivocal papillary areas, and most displayed evidence of an in situ component and/or had foci surrounded at the periphery by a myoepithelial cell layer as determined morphologically or by immunohistochemistry. [4][5][6] These findings are similar to papillary carcinomas of the breast (with or without invasion), which can also have residual myoepithelial cells at the periphery, 1,2 suggesting that some of these cases may represent papillary carcinoma of the breast, albeit with prominent cytoarchitectural features of papillary thyroid carcinoma. If this were the case, one might expect that such features need not be limited to cases of 'breast tumor resembling the tall-cell variant of papillary thyroid carcinoma', but may be common to papillary carcinomas of the breast in general.…”

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confidence: 99%

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Papillary carcinoma of the breast lacks evidence of RET rearrangements despite morphological similarities to papillary thyroid carcinoma

et al. 2009

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Rare breast neoplasms resembling the tall-cell variant of papillary thyroid carcinoma have been reported. In addition, papillary carcinoma of the breast occasionally displays nuclear features reminiscent of papillary thyroid carcinoma. In this study, we evaluated 33 intraductal/intracystic papillary carcinomas of the breast for the presence and extent of nuclear overlap, grooves, clearing, and inclusions, as well as features of the tall-cell or columnar-cell variants of papillary thyroid carcinoma. RET rearrangements were assessed in a subset of these cases. Paired probes localizing to the centromeric and telomeric ends of the RET gene on chromosome 10 were used for FISH using a break-apart approach. Single round and nested PCR was performed to detect RET/ PTC1, RET/PTC2, RET/PTC3 and ELKS-RET fusion transcripts. Nuclear overlap, grooves, stratification, and clearing were identified in 24 (73%), 14 (42%), 11 (33%), and 9 (27%) cases respectively, whereas nuclear inclusions and 'tall-cell' features were each seen in only one (3%) and two (6%) cases, respectively. Four of 19 tested cases displayed split FISH signals in a low percentage of cells and were considered borderline for RET rearrangement. All 19 tested cases with amplifiable RNA were negative for the four RET fusion transcripts evaluated by RT-PCR. Although papillary carcinomas of breast often display one or more cytoarchitectural features of papillary thyroid carcinoma, there is no evidence that RET rearrangements are involved.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Papillary carcinoma of the breast lacks evidence of RET rearrangements despite morphological similarities to papillary thyroid carcinoma

et al. 2009

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“…When papillary thyroid carcinoma with frequent recurrences and distant metastasis with aggressive clinical behavior is encountered, it has been pathologically diagnosed as a variant. [1][2][3] Among the variants of papillary thyroid carcinoma, the tall cell variant frequently has lymph node metastasis, distant metastasis, or both, with a strong association with a poorer prognosis, [4][5][6][7][8][9][10][11][12] behaving very differently from indolent or conventional papillary thyroid carcinoma.…”

Section: Sonographic and Clinical Findingsmentioning

confidence: 99%

Tall Cell Variant of Papillary Thyroid Carcinoma

Choi

Shin

Kim

et al. 2011

Journal of Ultrasound in Medicine

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apillary thyroid carcinoma, the most common form of thyroid carcinoma (85% of cases), is well known for its indolent clinical behavior with a high survival rate compared to those of other malignancies. When papillary thyroid carcinoma with frequent recurrences and distant metastasis with aggressive clinical behavior is encountered, it has been pathologically diagnosed as a variant. 1-3 Among the variants of papillary thyroid carcinoma, the tall cell variant frequently has lymph node metastasis, distant metastasis, or both, with a strong association with a poorer prognosis, 4-12 behaving very differently from indolent or conventional papillary thyroid carcinoma.The definition of the tall cell variant of papillary thyroid carcinoma was first proposed by Hawk and Hazard 13 as the presence of a papillary tumor whose cells are at least twice as long (tall) as they were wide. Since then, other pathologists have proposed more stringent criteria to diagnose the tall cell variant, including a composition of more than 50% tall cells, with a tall cell height of at least twice the width, eosinophilic tall cell cytoplasm, and nuclear features characteristic of papillary thyroid carcinoma. 14 This subtype, which constitutes less than 5% of all papillary thyroid carcinomas, 15 had not been studied much because of its rarity and difficult diagnosis, even with its aggressive clinical features and high mortality rates.A study performed in Japan suggested that an unidentified endemic factor is responsible for the lower prevalence and independent poor prognostic factors of the tall cell variant. 7 The aims of this series were to describe the clinical characteristics of the tall cell variant of papillary thyroid carcinoma and to characterize its highresolution sonographic features. Medicine, CASE SERIESWe retrospectively reviewed the clinical and sonographic features of 8 patients with 10 tall cell variants of papillary thyroid carcinoma. The mean age of the patients was 57 years (range, 34-72 years). The tumor sizes varied. Of the 8 patients, 5 had symptomatic masses, and 3 had incidentalomas. Three patients had recurrences and 1 died of pulmonary metastasis within a mean time of 30 months. The tall cell variants often appeared as microlobulated markedly hypoechoic nodules with microcalcifications and extrathyroidal extension on sonography and were always associated with lymph node metastasis. The tall cell variant of papillary thyroid carcinoma should be included in the differential diagnosis of an aggressive thyroid tumor with symptoms and cervical nodal metastasis.

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“…However, reflecting the uncertainty as to the nature and existence of this tumour as a distinct entity, several of its features are also seen in otherwise conventional PC variants [14], and variable terminology has been used to describe it [12][13][14][15][16]. Furthermore, despite being described as an oestrogen receptor (ER)-negative entity [16], a review of the literature reveals the existence of cases described as being ER-positive [13,15,17,18]. Finally, specific mutations involving the IDH2 gene have been reported in this entity [15,19], although it is not clear whether this gene mutation is a prerequisite for its diagnosis and is restricted to BTRTPC.…”

Section: Introductionmentioning

confidence: 99%

“…There is a PC showing histologic features similar to those of the tall cell variant of thyroid PC, termed "breast papillary tumour resembling the tall cell variant of thyroid papillary carcinoma" (BTRTPC) [12,13]. However, reflecting the uncertainty as to the nature and existence of this tumour as a distinct entity, several of its features are also seen in otherwise conventional PC variants [14], and variable terminology has been used to describe it [12][13][14][15][16]. Furthermore, despite being described as an oestrogen receptor (ER)-negative entity [16], a review of the literature reveals the existence of cases described as being ER-positive [13,15,17,18].…”

Section: Introductionmentioning

confidence: 99%

Breast Tumours Resembling the Tall Cell Variant of Thyroid Papillary Carcinoma: Are They Part of the Papillary Carcinoma Spectrum or a Distinct Entity?

et al. 2018

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Background: Papillary tumours of the breast are diagnostically challenging lesions and represent a wide spectrum of diseases from papilloma to invasive papillary carcinoma. A rare subtype of breast papillary tumour resembling the tall cell variant of thyroid papillary carcinoma (BTRTPC) has been described. The nomenclature of this entity, its relationship to other papillary tumours, and its nature, whether in situ or invasive, remain unclear. Methods: Seventy-five papillary carcinomas (PCs) of the breast previously diagnosed in routine practice were reviewed and the presence of features (n = 10) characteristic of BTRTPC were assessed to determine whether BTRTPC comprises a distinct entity or is part of the spectrum of the previously defined PC variants. Results: Nuclear overlapping and eosinophilic granular cytoplasm were seen in 81 and 75% of the cases, whereas nuclear grooves, nuclear clearing, and tall cells were noticed in 51, 42, and 38% of the cases, respectively; 27% of the cases showed macro- and micro-follicular architecture filled with colloid-like material. Five cases (7%) lacked oestrogen receptor (ER) expression. Co-existing invasive carcinoma was seen in 25 cases (33%). Two cases displayed several features characteristic of BTRTPC, and both were ER-negative. Conclusion: Features characteristic of BTRTPC overlap with other PCs of the breast. Molecular and immunohistochemical biomarkers are needed to provide objective diagnostic criteria for the characterisation of such lesions in routine practice.

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Breast Tumor Resembling the Tall Cell Variant of Papillary Thyroid Carcinoma: Report of 4 Cases With Evidence of Malignant Potential

Cited by 52 publications

References 10 publications

Papillary carcinoma of the breast lacks evidence of RET rearrangements despite morphological similarities to papillary thyroid carcinoma

Papillary carcinoma of the breast lacks evidence of RET rearrangements despite morphological similarities to papillary thyroid carcinoma

Tall Cell Variant of Papillary Thyroid Carcinoma

Breast Tumours Resembling the Tall Cell Variant of Thyroid Papillary Carcinoma: Are They Part of the Papillary Carcinoma Spectrum or a Distinct Entity?

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